Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F22%3A10445035" target="_blank" >RIV/00064165:_____/22:10445035 - isvavai.cz</a>
Alternative codes found
RIV/00064173:_____/22:43923706 RIV/00216208:11110/22:10445035 RIV/00216208:11120/22:43923706
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4dZ.3NlpNf" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4dZ.3NlpNf</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1182/blood.2022015560" target="_blank" >10.1182/blood.2022015560</a>
Alternative languages
Result language
angličtina
Original language name
Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse
Original language description
Central nervous system (CNS) relapse of Mantle Cell Lymphoma (MCL) is a rare phenomenon with dismal prognosis, where no standard therapy exists. Since the covalent Bruton tyrosine kinase inhibitor ibrutinib is effective in relapsed/refractory MCL and it penetrates the blood-brain barrier (BBB), on behalf of Fondazione Italiana Linfomi and European Mantle Cell Lymphoma Network we performed a multicenter retrospective international study to investigate the outcomes of patients treated with ibrutinib or chemo-immunotherapy. In this observational study we recruited MCL patients with CNS involvement at relapse, who received CNS directed therapy between 2000 to 2019. The primary objective was to compare overall survival (OS) of patients treated with ibrutinib or BBB crossing chemotherapy. A propensity score based on a multivariable binary regression model was applied to balance treatment cohorts. Eighty-eight patients were included. Median age at study entry was 65 years (range: 39-87), 76% were males, and median time from lymphoma diagnosis to CNS relapse was 16 months (range: 1-122). Patients were treated with ibrutinib (n=29, ibrutinib cohort), BBB crossing chemotherapy, i.e. high-dose methotrexate +- cytarabine (n=29, BBB cohort), or miscellaneous treatments (n=30, other therapy cohort). Both median OS (16.8 versus 4.4 months; p=0.007) and median PFS (13.1 versus 3.0 months; p=0.009) were superior in the ibrutinib cohort as compared to BBB cohort. Multivariable Cox regression model revealed that ibrutinib therapeutic choice was the strongest independent favorable predictive factor for both OS (HR: 6.8, 95% CI: 2.2-21.3; p <0.001) and PFS (HR 4.6, 95% CI: 1.7-12.5; p=0.002), followed by CNS progression of disease (POD) > 24 months from first MCL diagnosis (HR for death: 2.4, 95% CI: 1.1-5.3; p=0.026; HR for death or progression: 2.3, CI 95%: 1.1-4.6; p=0.023). The addition of intrathecal chemotherapy to systemic CNS directed therapy was not associated with superior OS (p=0.502), as the morphological variant (classical versus others, p=0.118). Ibrutinib was associated with superior survival compared to BBB penetrating chemotherapy in patients with CNS relapse of MCL, and should be considered as a therapeutic option.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30205 - Hematology
Result continuities
Project
<a href="/en/project/NU21-03-00386" target="_blank" >NU21-03-00386: Innovative treatment approaches and mechanisms of drug-resistance in mantle cell lymphoma</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Blood
ISSN
0006-4971
e-ISSN
1528-0020
Volume of the periodical
140
Issue of the periodical within the volume
17
Country of publishing house
US - UNITED STATES
Number of pages
10
Pages from-to
1907-1916
UT code for WoS article
000922881000008
EID of the result in the Scopus database
2-s2.0-85138866143